South Dakota
An obscure drug discount program stifles use of federal lifeline by rural hospitals • South Dakota Searchlight
Facing ongoing concerns about rural hospital closures, Capitol Hill lawmakers have introduced a spate of proposals to fix a federal program created to keep lifesaving services in small towns nationwide.
In Anamosa, Iowa — a town of fewer than 6,000 residents located more than 900 miles from the nation’s capital — rural hospital leader Eric Briesemeister is watching for Congress’ next move. The 22-bed hospital Briesemeister runs averages about seven inpatients each night, and its most recent federal filings show it earned just $95,445 in annual net income from serving patients.
Yet Briesemeister isn’t interested in converting the facility into a rural emergency hospital, which would mean getting millions of extra dollars each year from federal payments. In exchange for that financial support, hospitals that join the program keep their emergency departments open and give up inpatient beds.
“It wasn’t for us,” said Briesemeister, chief executive of UnityPoint Health-Jones Regional Medical Center. “I think that program is a little bit more designed for hospitals that might not be around without it.”
Nationwide, only about two dozen of the more than 1,500 eligible hospitals have become rural emergency hospitals since the program launched last year. At the same time, rural hospitals continue to close — 10 since the fix became available.
Federal lawmakers have introduced a handful of legislative solutions since March. In one bill, senators from Kansas and Minnesota list a myriad of tactics, including allowing older closed facilities to reopen.
Another proposal introduced in the House by two Michigan lawmakers is the Rural 340B Access Act. It would allow rural emergency hospitals to use the 340B federal drug discount program, which Congress created in 1992.
The 340B program, named after its federal statute, lets eligible hospitals and clinics buy drugs at a discount and then bill insurance companies, Medicare, or Medicaid at market rates. Hospitals get to keep the money they make from the difference.
Congress approved 340B as an indirect aid package to help struggling hospitals stay afloat. Many larger hospitals say the cash is used for community benefits and charity care, while many small hospitals depend on the drug discounts to help cover staffing and operational shortfalls.
Currently, emergency hospitals are not eligible for 340B discounts. According to a release from U.S. Rep. Jack Bergman (R-Mich.), the House proposal would “correct this oversight.” Backers of the House bill include the American Hospital Association and the National Rural Health Association.
In Iowa, Briesemeister said the 340B federal drug discount program “can be used for tremendous good.” The small-town hospital uses money it makes from 340B to subsidize emergency services and uninsured and underinsured patients who frequent the emergency department, he said.
Chuck Grassley, Iowa’s longtime Republican senator, shepherded the Rural Emergency Hospital program into law. His spokesperson, Gillie Maddox, did not respond directly to questions about why the federal law creating rural emergency hospitals omitted the 340B program. Instead, Maddox said the designation was a “product of bipartisan negotiations.”
A survey conducted by the health analytics and consulting firm Chartis, along with the National Rural Health Association, found that nearly 80% of rural hospitals had participated in 340B and nearly 40% said they reaped $750,000 or more annually from the program.
Sanford Health, a largely rural health system headquartered in Sioux Falls, South Dakota, considered converting a handful of smaller critical access hospitals into rural emergency hospitals.
Martha Leclerc, vice president of corporate contracting for Sanford, said the system analyzed how much revenue would be lost by closing inpatient beds, which is also a requirement of the emergency hospital program, and by being unable to file for drug discounts.
In the end, she said, switching did not “make a lot of sense.”
Creative thinking needed to save rural hospitals
While many rural hospitals are clamoring for the 340B provision to be added to the rural emergency hospital program, opponents have said 340B can be a cash cow for hospitals that don’t serve enough vulnerable patients.
Nicole Longo is deputy vice president of public affairs for the Pharmaceutical Research and Manufacturers of America, the nation’s largest, most influential pharmaceutical lobbying group. She wrote in a recent blog post that hospital systems and chain pharmacies are “exploiting the program” and said patients have not benefited from the growth in the program.
In an interview, Longo said PhRMA supports rural emergency hospitals being able to access 340B because they are treating “vulnerable patients in underserved communities” and are “true safety net providers.”
PhRMA, she said, wants to encourage a thoughtful conversation about “which types of hospitals should be in the program.” Last year, PhRMA formed an unlikely pact with community health centers to create the Alliance to Save America’s 340B Program, or ASAP 340B.
Vacheria Keys, associate vice president of policy and regulatory affairs at the National Association of Community Health Centers, said, “There is a new day of openness, from all parties.”
Use of the drug discount program skyrocketed after provisions in the Patient Protection and Affordable Care Act, passed in 2010, allowed hospitals and clinics to contract with an unlimited number of retail pharmacies, such as Walgreens and CVS, which are paid a fee to dispense the discounted drugs.
Adam J. Fein, president of the industry research organization Drug Channels Institute, reports that the 340B program is the second-largest federal drug program, trailing Medicare Part D. The flow of drugs purchased under the 340B program reached $53.7 billion in 2022, about $9.8 billion more than in 2021.
In response to the exploding use of contract pharmacies, pharmaceutical manufacturers have restricted the drugs they offer at a discount through the pharmacies. That throttling is affecting rural hospitals like Labette Health, a Kansas hospital whose president asked President Joe Biden for help in dealing with the pharmaceutical companies.
Rena Conti, an associate professor of markets, public policy, and law at Boston University’s Questrom School of Business, has studied the drug discounts for years and said she has “significant worries about expanding” the 340B program.
“There is a lot of money being generated in this program that we really can’t understand exactly how much that really is and exactly who it is benefiting,” Conti said.
At the same time, said Conti, a health care economist, giving rural hospitals access to the federal drug discounts “makes sense because they are hospitals that are serving particularly vulnerable patient populations.”
South Dakota
South Dakota man whose life sentence was commuted by Noem now implicated in his niece’s death
Two men, including one whose life sentence was commuted by then-South Dakota Gov. Kristi Noem, have been charged in the death of a 14-year-old girl whose body was found in a rural area five days after she went missing in March.
McKenna Wendel was reported missing March 13 and last seen alive in her hometown of Sioux Falls early on March 14. Her body was found outside Brookings, an hour’s drive north of Sioux Falls, on March 19.
Wendel’s uncle, Mark Milk, 51, also of Sioux Falls, now faces five counts related to her death. Milk was almost three decades into a life term on a manslaughter conviction when Noem commuted his sentence in 2023.
Wendel was raised by her grandparents, loved animals and had a “vibrant personality and a zest for life,” according to her obituary. She and her grandparents were Rosebud Sioux Tribe members and attended powwows often.
“She loved the singing and the beautiful sounds of the drums,” her obituary read.
Details about Wendel’s death remained thin as authorities who announced the charges in a Sioux City, Iowa, news conference Thursday kept close what they knew to protect their investigation.
Authorities have said an autopsy was done, but the findings have not been released. The cause and manner of Wendel’s death would not be released yet per Justice Department policy, said Leif Olson, U.S. attorney for northern Iowa.
Milk faces five counts including possession with intent to deliver cocaine that caused Wendel’s death. He is also charged with transportation of a minor with the intent to engage in criminal sexual activity, according to court documents.
Jon Rogness, 38, of Brookings faces conspiracy and accessory charges in an alleged attempt to cover up the crimes. The counts against the men were the “most serious, readily provable” charges and all originated in Iowa, Olson said.
“This is a horrific case,” FBI special agent Gene Kowel said. “There are no cases that we investigate that are more heart-wrenching and more tragic than the ones that involve children or the death of a child.”
Court records showed no lawyers listed for Milk and Rogness, and no relatives could immediately be located through phone records and social media to speak on their behalf.
In February 2023, Noem commuted Milk’s life sentence for a manslaughter conviction in an October 1993 stabbing death. Milk, then 19, had been involved in several altercations in the city of Winner that ended with the death of Shawn Peneaux, according to records.
Milk was in jail on unrelated allegations of driving under the influence and eluding police when Wendel’s body was found. His name came up in public discussion about the case from the start. But prosecutors, who finished their investigation in late May, did not formally link him to Wendel’s death until filing charges Wednesday.
South Dakota Attorney General Marty Jackley said in a late March news conference the decision to commute Milk’s life sentence was strictly Noem’s.
“It is fairly often that you see law enforcement oppose commutations,” Jackley remarked without commenting further on Noem’s decision.
The commutation documents were sealed and even he had not seen them, he noted.
The Associated Press left a message Thursday for Noem on seeking comment through NovaRed Mining, a Canadian firm she recently joined in a “strategic advisory role.”
A Republican, Noem, 54, was South Dakota’s lone congressperson from 2011 to 2019 and governor from 2019 to 2025. She was Homeland Security secretary before being fired in March by President Donald Trump amid criticism of her handling of the administration’s immigration crackdown and disaster response.
Trump praised Noem’s leadership and said he was making her special envoy for “The Shield of the Americas.” The new organization of Western Hemisphere nations is focused on supporting democracy and security in the region.
___
Gruver reported from Fort Collins, Colorado, and Billeaud from Phoenix, Arizona.
South Dakota
Road Trips Bring New Eyes to South Dakota
SIOUX FALLS, S.D. (KELO) — Bruno Calfa and his wife loaded their two dogs into an RV for a cross-country journey that started from Vancouver, Canada, and included a stop at Falls Park.
“We were passing by, and we were just like Googling what the things we must see when we are around and then we heard about the falls, and we just came to check it out,” Calfa said.
Calfa was impressed by the Sioux Falls scenery. But navigating a visit to Mount Rushmore was more challenging.
“We missed the four heads of the presidents. I should have turned left, I turned right, and got stuck in between bison for about 20-minutes. So they’re just liking the RV, checking the tires. It was interesting with two pups in the car,” Calfa said.
Seeing the country during a milestone anniversary is a family tradition for many visitors to South Dakota.
“When it was the 200th anniversary, I remember that one when we were kids. We’ve always taken road trips with our family, so that’s what we like to do, we like to drive,” Sasha Wilmes of St. Louis said.
Walking is good, too. We found these couples checking out the sites in downtown Sioux Falls.
“Yesterday, we did the southern part of the Phillips Avenue SculptureWalk, and that was great. Really nice shops. We both grew up in central Illinois, and it reminds me a lot of some of the towns in central Illinois,” Dave Massanari of Shapleigh, ME, said.
These first-time visitors shared their first impressions of South Dakota.
“It’s pretty flat, so far, on this end of South Dakota. It’s the old sea bottom, right,” Bruce Bagley of Overland Park, KS said.
The people we spoke with say there’s something about seeing America, and South Dakota in particular, from behind the wheel of a car, that you just don’t get flying in a plane from airport to airport.
“It’s a better view than from 30,000 feet. It’s much more interesting, you see different types of buildings and architecture and geography, much better than you would from the air,” Bagley said.
“You can just experience the landscape. You can stop when you want to if you see something interesting, you can get out,” Corinna Warren of Omaha, NE said.
The Great American Road Trip promotion is expected to draw more visitors to South Dakota during the crucial summer tourism season.
“Fingers are crossed that we’re going to have a better year than we did last year. Last year was a little flat. So we’re really hoping that our numbers are going to go up,” Experience Sioux Falls CEO Teri Schmidt said.
Visitors to the state say they haven’t been sidetracked by high gas prices or inflation.
“We kind of had that planned ahead of time, and we are going, so we have a Vrbo, we have a home base, and then we’re going to go out to different places from there. So that’s kind of how we’re going to do it. So we travel pretty economically anyway, so it’s fine,” Wilmes said.
“Some people have said we’re going to travel anyway, regardless of gas prices. Others have said we’re going to go on a 5-day trip, not a 10-day trip. And if they go on those shorter trips, Sioux Falls is perfect for that,” Schmidt said.
That’s why visitors from as far away as Canada are willing to go the extra mile and then some to come here.
“Most of the time, you hear about the East and the West, California, New York, or Florida. But you don’t really get to know the middle of the country. But there are so many beautiful places,” Calfa said.
And travelers say there’s no better time to soak in all that scenery than during America’s 250th anniversary.
“We grew up in the East, where it all began, where the Revolution was taking place, and there are historical markers everywhere,” said Anne Bagley of Overland Park, KS.
The nation’s past provides a roadmap to the present and future whenever people pull off and explore the vistas along their journey.
South Dakota
SD Lottery Powerball, Lotto America winning numbers for June 17, 2026
The South Dakota Lottery offers multiple draw games for those aiming to win big.
Here’s a look at June 17, 2026, results for each game:
Winning Powerball numbers from June 17 drawing
03-26-49-53-61, Powerball: 12, Power Play: 2
Check Powerball payouts and previous drawings here.
Winning Lotto America numbers from June 17 drawing
11-16-18-33-51, Star Ball: 09, ASB: 05
Check Lotto America payouts and previous drawings here.
Winning Dakota Cash numbers from June 17 drawing
08-11-12-25-26
Check Dakota Cash payouts and previous drawings here.
Winning Millionaire for Life numbers from June 17 drawing
02-04-07-16-21, Bonus: 03
Check Millionaire for Life payouts and previous drawings here.
Feeling lucky? Explore the latest lottery news & results
Are you a winner? Here’s how to claim your prize
- Prizes of $100 or less: Can be claimed at any South Dakota Lottery retailer.
- Prizes of $101 or more: Must be claimed from the Lottery. By mail, send a claim form and a signed winning ticket to the Lottery at 711 E. Wells Avenue, Pierre, SD 57501.
- Any jackpot-winning ticket for Dakota Cash or Lotto America, top prize-winning ticket for Lucky for Life, or for the second prizes for Powerball and Mega Millions must be presented in person at a Lottery office. A jackpot-winning Powerball or Mega Millions ticket must be presented in person at the Lottery office in Pierre.
When are the South Dakota Lottery drawings held?
- Powerball: 9:59 p.m. CT on Monday, Wednesday, and Saturday.
- Mega Millions: 10 p.m. CT on Tuesday and Friday.
- Lucky for Life: 9:38 p.m. CT daily.
- Lotto America: 9:15 p.m. CT on Monday, Wednesday and Saturday.
- Dakota Cash: 9 p.m. CT on Wednesday and Saturday.
- Millionaire for Life: 10:15 p.m. CT daily.
This results page was generated automatically using information from TinBu and a template written and reviewed by a South Dakota editor. You can send feedback using this form.
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